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Paroxysmal Nocturnal Hemoglobinuria and Marrow Failure Treated by Infusion of Marrow from an Identical Twin

Grant support: Grants CA 10895, CA 05231, CA 15704 from the National Cancer Institute and RR-37 from the General Clinical Research Center, National Institutes of Health. Dr. Fefer is a Scholar of the Leukemia Society of America and a Sinsheimer Fellow. Dr. Freeman was supported during a portion of this work as a Medical Research Council of Canada Fellow. Dr. Thomas is a recipient of Research Cancer Award AI 02425 from the National Institute of Allergy and Infectious Diseases.

▸Requests for reprints should be addressed to Alexander Fefer, M.D.; Department of Medicine, University of Washington; Seattle, WA 98195.

An 18-year-old white Canadian male patient with paroxysmal nocturnal hemoglobinuria and refractory marrow failure received a marrow infusion from his normal identical twin brother without prior ablation of the patient's marrow by drugs or irradiation. After 2 years of follow-up, the patient is well with no evidence of clinical disease or significant hematological abnormality. The results suggest that normal marrow stem cells can have a selective advantage over the abnormal paroxysmal nocturnal hemoglobinuria clone.

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